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Background The serious health consequence that comes from disrupted and poor sleep quality is an increased risk for cardiac diseases and diabetes. The goal was to investigate the association of insulin resistance with sleep complains in ten years follow-up. Methods A randomized epidemiological follow up study with 835 subjects: 300 (35.9%) men and 535 (64.1%) women was performed in 2003 and in 2013. The Basic Nordic Sleep Questionnaire was used to assess the frequency of sleep complaints in the first and the follow up survey. Insulin resistance was evaluated by homeostasis model assessment of insulin resistance (HOMA-IR). The contingent was divided into 2 groups: insulin resistance group (HOMA-IR> 2.7) 33% and No- insulin resistance group (HOMA-IR ≤2.7) 67%. Results A statistically significantly increased number of persons with diabetes mellitus and high body mass index was seen in both groups after 10-year period; however, in insulin resistance group an increase was more expressed. A statistically significant change of sleep complains after 10-year period was seen in insulin resistance group; while in no-insulin resistance group there were no significant modifications. Individuals with insulin resistance were more likely to complain of difficulty falling asleep (from 11.2% to 17.8%, p = 0.031) and early wake up in the morning (from 12.6% to 24.5%, p = 0.003) after 10-year period. Daytime sleepiness was also more frequently observed among persons with insulin resistance (from 9.0% to 14.7, p = 0.037). They were more likely to use sleeping pills (from 4.0% to 8.3%, p = 0.034) and, not surprisingly, were more likely to use alcohol to improve sleep (from 1.1% to 4.4%, p = 0.012). Conclusions A statistically significant increase in body mass index and diabetes as well as difficulty to fall asleep, early waking up in the morning, severe drowsiness in the morning and daytime sleepiness was found in ten years follow-up in insulin resistance group. Key messages A statistically significant increase of sleep complains after ten years follow-up was seen in insulin resistance group. Insulin resistance and metabolic syndrome in parallel with disturbed sleep may lead to the development of diabetes in follow-up.

Background Insulin resistance is the primary cause of metabolic syndrome, which in turn reflects a real variety of risk factors, closely linked to each other. Thus, we aimed to investigate health-related quality of life scores according to the presence of insulin resistance among citizens of Palanga in Lithuania, in the survey in 2003 and 2013. Methods A randomized epidemiological study was performed out for 835 subjects. All study participants were evaluated according to for socio-demographic characteristics, behavioral factors, health-related quality of life and self-perceived health using questionnaires. Fasting blood samples were draw from all participants for biochemical tests for the glucose and insulin. Insulin resistance was evaluated by the homeostasis model assessment of insulin resistance. Results All study participants were stratified into groups without and with insulin resistance in the survey in 2003 and 2013 years follow up. Participants with insulin resistance were more likely to be male, with higher body mass index, had lower than higher education, and with moderate self-related health. In subjects with insulin resistance, after adjusting with various factors, logistic regression analysis showed, that within 10 years, a significantly higher chance of deteriorating health-related quality of life in the areas of: physical functioning (odss ratio [OR] = 1.15, p < 0.001), emotional role limitations (OR = 1.07, p = 0.034), social functioning (OR = 1.26, p = 0.004), pain (OR = 1.09, p = 0.005) and general health perception (OR = 1.07, p = 0.022). Conclusions People with insulin resistance are significantly more likely to have a deterioration in their health-related quality of life in the areas of physical functioning, emotional role limitations, social functioning, pain and general health perception after 10 years period. Key messages Over the course of ten years, significant changes were observed in domains of physical functioning, social functioning and general health perception in subjects with insulin resistance. Results of this study provide evidence that individuals with insulin resistance have a significantly higher chance of deteriorating health-related quality of life within 10 years.

Aims Emerging studies suggest an association exists between coronary artery disease (CAD) and the development of neurodegenerative diseases, with CAD acting as a precursor. Our study aimed to investigate the relationship between baseline measures of cognitive functioning and long-term health-related quality of life (HRQoL) in individuals with CAD with specification to Type D personality traits and sex. Methods and results This prospective observational cohort study consisted of 864 participants (mean age 58 SD = 9 years, 74.0% men) with CAD after acute coronary syndrome. Baseline characteristics included comprehensive cognitive testing, measures of sociodemographic and clinical factors, and psychological assessment scales, such as Type D personality scale and the Hospital Anxiety and Depression scale. The Minnesota Living with Heart Failure Questionnaire assessed participants’ HRQoL, conducted through phone interviews at baseline, every 6 months for up to 2 years, and after 5 years. Cognitive functioning correlated with HRQoL at all time intervals over the 5-year follow-up. Regarding sex and Type D personality, significant differences emerged in associations between impaired cognitive functioning at baseline and HRQoL measured over the period of 5 years. Men participants with characteristics of Type D personality were especially vulnerable to impaired cognitive functioning affecting the 5-year quality of life. Conclusion Men with CAD who obtained scores indicating characteristics of Type D personality were significantly more likely to have lower baseline cognitive functions and long-term HRQoL outcomes. This information could inform healthcare practitioners to screen for personality characteristics and closely follow-up those at a greater risk.

Background: Individuals with insulin resistance (IR) have a high risk of diabetes or metabolic syndrome, and they are more likely to have depression. Furthermore, IR by itself is a major cardiovascular risk factor in healthy persons. Thus, we aimed to investigate IR in association with thyroid function, psychoemotional state, and cardiovascular risk factors among 45–84-year-old citizens of Palanga. Methods: A randomized epidemiological study was performed with 850 subjects. All participants were evaluated for sociodemographic, clinical, and cardiovascular risk factors and biochemical analysis. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR). Results: All study participants were stratified into groups without IR (HOMA-IR ≤ 2.7) and with IR (HOMA-IR &gt, 2.7). The analysis of parameters between the two study groups showed some statistically significant relationships between IR and cardiovascular risk factors. The predictable accuracy was presented using receiver performance characteristic curves for HOMA-IR scores in women and men separately. If the HOMA-IR score is higher than 3.45, individuals are significantly more likely to have type 2 diabetes mellitus (T2DM). Conclusions: An increase of fasting glucose and more frequent incidence of metabolic syndrome, diabetes, and cardiovascular diseases in subjects with IR are associated with the prevalence of cardiovascular risk factors. There was no significant association between thyroid function and HOMA-IR. HOMA-IR cut-offs could predict the presence of T2DM.

Background: The impact of removing the upper airway lymphoid tissue and in particular, tonsillectomy, in adults with OSA has not been demonstrated in large populations. Aims: To compare the severity of OSA and the prevalence of cardiovascular, metabolic and respiratory co-morbidities between patients with OSA who had undergone previous tonsillectomy and those who had not. Methods: The 19,711 participants in this study came from the European sleep apnea database (ESADA) which comprises data from unselected adult patients aged 18–80 years with a history of symptoms suggestive of OSA referred to sleep centers throughout Europe. Results: There were no differences between the two groups in terms of sex ratio and age (146 patients with previous tonsillectomy vs. 19565 patients without). Patients who had undergone tonsillectomy had a lower body mass index (29.3 ± 5.2 kg/m2 vs 32.2 ± 6.6 kg/m2, p < 0.001), lower subjective sleep latency (17.1 ± 17.8 min vs 25.5 ± 30.4 min, p = 0.001), lower ODI (15.7 ± 18.3 events/hour vs 30.7 ± 26.1 events/hour, p < 0.001), and SpO2, European Respiratory Society, ERS, The ESADA network has previously received support from the European Union COST action B26 and the European Respiratory Society. We gratefully acknowledge unrestricted seeding grants from ResMed Inc and Philips Respironics Inc. for establishment of the organisation and the database. Excellent technical assistance in terms of centre monitoring and database maintenance was provided by Ann-Christin Lundquist, RN and Jeanette Norum, RN.

Aim of the study was to evaluate the associations among poor sleep, anxiety and depression in relation to age and year of studying among the students. Methods. The study sample consisted of 400 Klaipeda State University of Applied Sciences students (96.8% female) and 393 The Lithuanian Maritime Academy students (78.9% male), from 18 to 46 years of age. Pittsburgh Sleep Quality Index (PSQI) was used for subjective sleep quality evaluation. Hospital Anxiety and Depression (HAD) scale was used to identify depression and anxiety. PSQI score ≤ 5 was evaluated as good sleep quality; > 5 – poor sleep. HAD score from 0 to 7 was evaluated as no depression or anxiety, score >7 indicated depression and/or anxiety. Additional questions about respondents’ age, gender, study programme and year of the studying were used. The Chi-square test or Fisher exact tests were used to estimate association between categorical variables. Student’s t test was used to compare means and z criteria was used to test the difference in two population proportions. Binary logistic regression analysis was performed to evaluate the factors influencing poor sleep. Results. Health sciences students, as compared to maritime students, had higher prevalence of poor sleep (69.8% vs 45.0%) and anxiety (55.5% vs 41.7%). Depression score was higher among the students with poor sleep, as compared to good sleep, respectively 4.38 vs 3.20 (20 yrs), 5.16 vs 3.29 (21 yrs), 5.38 vs 3.22 (≥ 22 yrs). Anxiety score was higher among the students with poor sleep, as compared to good sleep, respectively 7.89 vs 6.11 (18-19 yrs), 8.73 vs 6.12 (20 yrs), 10.40 vs 6.51 (21 yrs), 10.58 vs 6.40 (≥ 22 yrs). The risk of poor sleep was significantly decreased by the studying marine sciences (OR=0.365) and increased by anxiety (OR=1.172), p

Evidence on the association between insomnia symptoms and mortality is limited and inconsistent. This study examined the association between insomnia symptoms and mortality in cohorts from three countries to show common and unique patterns. The Finnish cohort comprised 6605 employees of the City of Helsinki, aged 40-60 years at baseline in 2000-2002. The Norwegian cohort included 6236 participants from Western Norway, aged 40-45 years at baseline in 1997-1999. The Lithuanian cohort comprised 1602 participants from the City of Palanga, aged 35-74 years at baseline in 2003. Mortality data were derived from the Statistics Finland and Norwegian Cause of Death Registry until the end of 2012, and from the Lithuanian Regional Mortality Register until the end of 2013. Insomnia symptoms comprised difficulties initiating sleep, nocturnal awakenings, and waking up too early. Covariates were age, marital status, education, smoking, alcohol, physical inactivity, obesity, diabetes, cardiovascular diseases, depression, shift work, sleep duration, and self-rated health. Cox regression analysis was used. Frequent difficulties initiating sleep were associated with all-cause mortality among men after full adjustments in the Finnish (hazard ratio 2.51; 95% confidence interval 1.07-5.88) and Norwegian (hazard ratio 3.42; 95% confidence interval 1.03-11.35) cohorts. Among women and in Lithuania, insomnia symptoms were not statistically significantly associated with all-cause mortality after adjustments. In conclusion, difficulties initiating sleep were associated with mortality among Norwegian and Finnish men. Variation and heterogeneity in the association between insomnia symptoms and mortality highlights that further research needs to distinguish between men and women, specific symptoms and national contexts, and focus on more chronic insomnia.

The study aimed to examine the association between type D personality trait and sleep quality in coronary artery disease (CAD) patients with and without obstructive sleep apnea (OSA) and to explore the mediating effects of anxiety and depression symptoms.A cross-sectional study was performed in 879 CAD patients attending cardiac rehabilitation program (mean age 57.8 years; SD = 9.0; 75% men). Participants underwent full-night polysomnography and were classified in OSA (n = 349) and no OSA (n = 530) groups. Patients were evaluated for type D personality, subjective sleep quality (Pittsburgh sleep quality index), and symptoms of anxiety and depression (hospital anxiety and depression scale).Patients with type D personality reported poorer subjective sleep quality than non-type D patients irrespective of the presence of OSA. Type D and negative affectivity (NA) were associated with worse subjective sleep quality in patients with OSA and without OSA. The mediational analysis revealed that type D and NA were indirectly associated with Pittsburgh sleep quality index through anxiety and depression symptoms in no OSA and OSA patients.In CAD patients, type D personality and NA are associated with worse subjective sleep quality and this association is mediated by depression and anxiety symptoms irrespective of OSA presence.

Apklausos tikslas buvo įvertinti miego kokybę, depresijos ir nerimo pasireiškimą, priklausomai nuo studentų lytes, amžiaus, kurso ir mokslo institucijos. Metodai: tyrimo imtis buvo sudaryta iš 400 (96,8 proc. Moterys) Klaipėdos valstybinės kolegijos Sveikatos mokslų fakulteto studentų ir 393 (78,9 proc. vyrai) Lietuvos aukštosios jūreivystės mokyklos studentų, kurių amžius buvo nuo 18 iki 46 metų. Subjektyviam miego kokybės vertinimui buvo naudotas Pitsburgo miego kokybės klausimynas (PSQI), o depresijai ir nerimui nustatyti buvo naudojamas HAD klausimynas. Studentai, kurių Pitsburgo miego kokybės indeksas buvo ≤5, buvo priskiriami gerai miegančių, o >5 – prastai miegančių grupei. HAD klausimyno reikšmės, kurių reikšmį buvo ≤7, nerodė depresijos ar nerimo pasireiškimo, o reikšmės, kurios buvo >7, rodė depresijos ar nerimo pasireiškimą. Rezultatai: beveik dvigubai daugiau sveikatos mokslų fakulteto studentų skundėsi prastu miegu (61,2 proc.) nei jūreivystės studentų (38,8 proc.), p5 – poor sleep. HAD score from 0 to 7 was evaluated as no depression or anxiety, score >7 indicated depression and/or anxiety. Results. Lithuanian Maritime Academy students had significantly lower prevalence of poor sleep, as compared to the students of the Faculty of Health Sciences, 38.8% vs 61.2%, p

Background: seafaring is an occupation with specific work-related risks, causing increased morbidity and mortality. Nevertheless, the research in the area of marine students ‘sleep quality and mental health is lacking in Lithuania, as well as other European countries. The aim was to overview scientific findings, related with occupational health risks in a seafaring population and asses the frequency of poor sleep and the relations among poor sleep, anxiety and depression in the sample of maritime students. Methods and contingent. The scientific literature review, based on PubMed sources analysis, related to occupational health risks in seafaring population, was performed. Questionnaire survey was conducted in 2014 at The Lithuanian Maritime Academy, 393 (78.9 % of them males) students participated. Sleep quality was evaluated by Pittsburg Sleep Quality Index. Anxiety and depression were assessed by Hospital Anxiety and Depression scale. Sociodemographic questions were used. The Chi-square test r Fisher exact test was used to estimate association between categorical variables. P- Values less than 0.05 were interpreted as statistically significant. Results. Scientific literature review indicate that highly stressful and exhausting working conditions on ships can lead to depression, insomnia, various types of cancer, cardiovascular, communicable, blood-born and sexually transmitted diseases. Poor sleep was found in 45.0 % of the students. Mild depression was established in 6.9 %, moderate in 2.3 %, Severe in 0.8 % of the students. Mild anxiety was found in 19.1 %, moderate in 14.8 % and Severe in 7.9 % of the students. Depression (score ?8) was significantly more frequent among third (fourth) year students (22.2 %) with poor sleep, as compared to the students demonstrating good sleep (2.7 %). Marine engineering programme students whose sleep was poor more often had depression (22.0 %), as compared to the students whose sleep was good (5.7 %). Conclusions. Seafarers have higher hospitalization and mortality rates than age-matched peers, due to exposure to unique occupational health risk factors. Maritime students had poor sleep more than anxiety or depression. Anxiety and depression were more common among the students demonstrating poor sleep rather than good sleep. Key words: Maritime students, Sleep quality, Anxiety, Depression, Occupational health.